Government health 'reforms': The Con-Dems' future doesn't work

Tens of thousands of health workers' jobs are being axed by NHS trusts. This is a result of billions of pounds of 'efficiency savings' initiated by the previous Labour government and carried on with a vengeance by the Con-Dem coalition. These spending cuts are also leading to the closures of wards and A&E departments in hospitals.

The drive to convert all NHS hospitals to 'Foundation Trust' status - again, initiated by the last Labour government - will cement the NHS's 'internal market' (in which private health care companies now have a significant stake) and accelerate cutbacks and closures.

On top of this assault on the NHS comes the latest health 'reform' plans of the government in its misnamed white paper: 'Equity and excellence: Liberating the NHS'. Its envisaged changes will effectively hand over the bulk of the health budget to privately run corporations whose profit-driven motive will result in further cutbacks and the break-up of the NHS as we know it.

However, the government will face enormous opposition from NHS workers, trade unions, and the wider community in trying to implement this privatisation programme.

Rob Rooney

Plymouth health workers have been treated to a glimpse of their future - privatised or disappearing services for patients and worse terms and conditions for staff.

Unelected, unaccountable health bosses were due to meet on 17 March to rubber-stamp their decision to turn 1,984 Plymouth primary care trust (PCT) employees over to a 'social enterprise'.

Recently, a meeting of approximately 60 members of Unison Plymouth Community NHS Trust branch heard a health worker from Hull, tell of her experience since Hull PCT became the first in the country to transfer to a social enterprise in June 2010.

She explained that staff were constantly told there was nothing to worry about, that they wouldn't notice the difference. "We thought 'we've had three changes of name and three changes of people in seven years, this is just another re-structure'. Then slowly people realised 'Oh my God, this is really different' ."

The limited safeguards negotiated under Agenda for Change, such as annualised hours, soon went and the number of disciplinary hearings went through the roof.

The health worker warned: "Don't think your contracts will be protected because they won't." Already, custody nurses have gone over to a private company; the award-winning sexual health service is rumoured to be next. "If it's not profitable, if it costs too much in staff or you can't easily see how it makes money, cuts will be made."

There has been expansion in one direction - a smart new finance suite, housing an expanded human resources staff, who are looking at existing terms and conditions and policies.

Health bosses have ignored the opinions of staff and have not consulted with the public. In the South West (where there are seven PCTs set to transfer) Unison had a staff survey with 1,100 responses, all saying 'no'. The strategic health authority (SHA) has no survey at all of public opinion.

Plymouth Unison full-time officer, Claire Jones, said the plan is for PCT staff to be registered as a "community interest company" from 1 April. Staff will be issued with new fixed-term contracts but Claire said they will not be worth the paper they are written on. Unison has obtained a letter from the Department of Health which confirms this.

"You will not be able to enforce it - services will be market-tested and opened up to the private sector. Make no mistake, it's not the NHS any more."